title: The Mediterranean diet in relation to mortality and CVD: a Danish cohort study.
abstract: The aim of the present study was to determine whether the Mediterranean Diet Score (MDS) is associated with reduced total mortality, cardiovascular incidence and mortality in a Danish population. Analyses were performed on 1849 men and women sampled during the 1982-83 Danish MONICA (MONItoring trends and determinants of Cardiovascular disease) population study, whose diet was assessed by means of a validated 7 d food record. The adherence to a Mediterranean dietary pattern was calculated by three different scores: one based on a classification excluding ingredients from mixed dishes and recipes (score 1); another based on a classification including ingredients (score 2); the last one based on a variant of the latter including wine instead of alcohol intake (score 3). The association between these scores and, respectively, total mortality, cardiovascular incidence and mortality was tested by a Cox proportional hazards model adjusted for several potential confounders of the association. Generally, all three scores were inversely associated with the endpoints, although associations with score 1 did not reach statistical significance. Score 2 was inversely associated with total mortality (hazard ratio 0·94; 95 % CI 0·88, 0·99). This association was confirmed for total cardiovascular as well as myocardial infarction (MI) incidence and mortality, but not for stroke. Score 3 was slightly more associated with the same outcomes. All associations were also resistant to adjustment for covariates related to potential CVD pathways, such as blood lipids, blood pressure and weight change after 11 years of follow-up. In a Danish cohort, the MDS was inversely associated with total mortality and with cardiovascular and MI incidence and mortality, but not with stroke incidence or mortality.
authors.affiliation: Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Sahlgrenska Academy, Box 454, SE 405 30, Göteborg, Sweden.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Tognon
authors.affiliation: Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Sahlgrenska Academy, Box 454, SE 405 30, Göteborg, Sweden.
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.affiliation: Research Unit for Dietary Studies at the Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark.
authors.forename: Ditte
authors.initials: D
authors.lastname: Sæbye
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Melbourne, VIC, Australia.
authors.forename: Karen Z
authors.initials: KZ
authors.lastname: Walker
authors.affiliation: Research Unit for Dietary Studies at the Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark.
authors.forename: Berit L
authors.initials: BL
authors.lastname: Heitmann
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D015930:Diet Records; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D016016:Proportional Hazards Models; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D011795:Surveys and Questionnaires